Lateral collateral ligament = worse if injured. This is because the medial tibial plateau forms a deeper and more stable socket with the femoral condyle than the lateral plateau.

What’s the unhappy triad?

Results from a strong force applied to the lateral aspect of the knee.

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Where to the anterior and posterior cruciate ligament extend from?

Extend from the intercondylar eminence of the tibia to the intercondylar notch of the distal femur

ACL attaches to posterior aspect of femoral notch and the anterior intercondylar region of the tibia.

PCL goes from medial edge of lateral femoral condyle and the roof of the intercondylar notch. It stretches posterolaterally towards to posterior surface of the tibia.

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What do the ACL and PCL do?

ACL resists anterior translation and medial rotation of the tibia in relation to the femur

PCL prevents posterior dislocation of the tibia on the femur

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How is the ACL usually torn and what does the patient feel?

As a result of quick deceleration, hyperextension or rotational injury The tibia can slide anteriorly under the femur Usually feel a popping sensation in the knee.

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How is the PCL damaged?

Dashboard injury = flexion of the knee and a force placed on the upper tibia, displacing it posteriorly

Also during football when a player falls on a flexed knee when their ankle plantar flexed

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What’s prepatella bursitis and how will patients present?

Inflammation of the prepatella bursa. A superficial bursa between the skin and patella.

Inflammation causes increase in fluid.Patient has pain and swelling, cant kneel on affected knee and cant walk due to pain. Usually a history of repetitive trauma to the bursa e.g kneeling on the ground to scrub = housemaids knee.

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What is infrapatella bursitis and how does it occur?

Two bursa - one below the knee cap and one deep between the patella tendon and tibial bone (shin).

Usually superficial one is inflammed

Occurs due to repeated micro trauma e.g repeated kneeling. Clergymans knee = common nickname and reflects upright position of kneeling.

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What’s suprapatella bursitis

Swelling within the suprapatellar pouch presents with a knee effusion.

It’s usually a sign of pathology in the knee. Causes can be osteoarthritis or rheumatoid arthritis, gout, infection, repetitive microtrauma, ect.

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What’s osgood schlatters disease and what do patients complain of?

Inflammation of the patellar ligament at its insertion into the tibial tuberosity. Commonly occours in teenagers who play sport.

Complain of intense knee pain during running, jumping, squatting, ascending and descending stairs and during kneeling. Resolves with rest and ice.

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What are the symptoms of osteoarthritis in the knee?

Pain comes and goes at varying levels of intensityPain precipitated by activities e.g bending, kneeling, squatting or climbing stairs Pain is worse after prolonged inactivity or rest e.g getting out of bed in the morning. Knees may buckle when going downstairs due to weakness of quads causing instability

Loss of articular cartilage = bone rubs on bone = firiction can be felt as crepitus. An effusion may develop.

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What are the risk factors with OA and what will you see on an X-ray?

Risk factors- gender (female)- age- other conditions effecting the joint- previous trauma to the joint- family history

X ray- osteophytes- narrow joint space

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What is septic arthritis of the knee joint and what is the most common cause?

Inflammation caused by the invasion of micro organisms in the joint space

What are the risk factors for septic arthritis?

Prosthetic joint replacement also. May become symptomatic months or years after initial operation maybe due to delayed wound healing. Biofilm produced by staph epidermis protects bacteria from destruction by antibodies or bodies immune response.